RESEARCH ON LYMPH CIRCULATION IN HUNGARY

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• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP81-00280R000200100024-9
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• Document Page Count: 11
• Document Creation Date: December 22, 2016
• Document Release Date: April 11, 2011
• Sequence Number: 24
• Publication Date: November 9, 1956
• Content Type: REPORT

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RESEARCH ON LYMPH CIRCULATION IN HUNGARY
A Magyar Tudomany Tiz Eve
1945-1955 LTen Years of
Science in Hungary 1945-1957,
1955, Budapest, Pages 213-222
One of the most valuable chapters of lymph research is now being
written in Hungary, following the line developed by Sandor Koranyi. By
way of contrast, a negligible number of research projects were concerned
with the physiology and pathology of the lymphatic system prior to
Liberation. The earlier Hungarian technical literature in this field
records smaller research projects by Buday, Genersich and Regeczy
related to problems concerning the lymphatic system. In addition to
these three researchers Koranyi and his pupil Roth postulated a
brilliant theory of lymph circulation which still holds promise. However,
these constitute the total of significant preliberation Hungarian lit-
erature in the field of lymph circulation.
The fact. practically no Hungarian and very few foreign researchers
were. active in the field of the physiology and pathology of lymph cir-
culation after the turn of the century is due in large part to the world-
wide interpretation of the classical studies of Starling as implying that
edema and fluid absorption could be satisfactorily explained without
attributing a role to the lymphatic system in the pathological process.
As early as the 1930ts the present author emphasized the fact that
the solution of the many unsolved problems connected with edema is
possible only through investigation of the lymphatic system. The studies
conducted by the author and his associates, Doctors Mihaly Fold! and
Gyorgy Szabo, have encompassed many years. This study, which originally
was aimed at discovering the origin of edema, branched out to include
investigation of lymph circulation and the importance of the latter not
only in the origin of edema, but in the entire fluid balance of the body
and in the functioning of the internal organs.
The sum total of the present conception of the conditions under
which edema arises is derived from Starling. He was the first to point
out the fact that two forces are opposed in the blood capillaries: one
is the force which tends to force fluid from the capillary, which is
due to blood pressure, and the other tends to reabsorb fluid which is
in the tissue spaces, which is the reabsorbing power of proteins, or
colloidal osmotic pressure. The establishment of this fact led to an
attempt to explain the for-nation of an edema in the light of these
forces. Krogh and his associates continued investigations along this
line after Starling, and the present author also participated in this
research 20 years ago. On this basis an edema results when the forces
tending to express fluid from the capillaries are greater than those
tending toward their reabsorption. This is the classical teaching of
Starling and in its essence is still a generally accepted viewpoint.
Upon careful reconsideration, however, it was realized that this ex-
planation alone does not satisfactorily explain all types of edema. It
is known, for example, that following the radical removal of the
axillary lymphatic nodes in the course of surgical excision of mammary
cancer an extreme edema may appear in the arm after a certain time,
often without disturbance of bicod circulation. Such cases cannot be
explained on the basis of the above theory alone, because there has
been no increase in capillary pressure, and no quantitative or quali-
tative change in the composition of protein composition. Thus it appears
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that an edema may arise even without any pathological change in the factors
taken into account in the Starling-type explanation, but when there is
some sort of disruption of the lymph circulation. Another case in point
is presented by edema accompanying heart disease. According to the old
theory edema in decompensated heart disease patients was explained by an
increase in filtration pressure and the fluid oozes into the interstitial
spaces of connecting tissue. However, if the lymphatic system is un-
impaired, it. is not understood why the oozing fluid is not carried away
by the lymph circulation. Thus at least 2 types of edema are not explained
by the classical theory alone. Also, it 7.s not understood why the fluid
is not absorbed in inflammatory edema, where protein-containing fluid
leaks from the blood vessels into the tissue as a result of an increase
in capillary permeability, and why this fluid is not carried away by the
lymph circulatory system.
The #ir3t problem investigated b..? the above research group was why
edema occurs in thrornbophlebitis (infection of the veins). This type of
edema is in the class of common pathographies. According to the Starling
theory, closure of an artery results in increased blood pressure in the
capillaries, which in turn results in an increase in the escape of fluid.
Here the question also arises, why the escaping fluid is not carried away
by the lymphatic circulation. The matter is further complicated by the
fact that it has been observed that tying off of the main vein, the vena
cava inferior, does not always result in edema. This operation recently
has been used as a therapeutic measure in edemic heart patients, and
experience has shown that following this operation edema of the lower
extremities not only does not increase, but often disappears. The French
clinical specialist was the first to demonstrate that edema can be
terminated in thrombophlebitic pycients through the novocain narcoti-
zation of certain nerve trunks. At the request of the author, I.mre
Littmann and Pal rTubanyi studied this method and have obtained very good
results.
The effect of novocaine, or sympathectomy (obliteration of certain
nerves), cannot be explained by the Starling theory. The injection of
novocaine has no effect on the conditions produced by closure of
arteries. This is the reason why the research group thought the dis-
ruption must be due to the lymphatic ducts. Therefore, it was in-
vestigated whether spasms of the lymph ducts could take place, similar
to arterial spasms. It must be noted that lymph ducts have their own
innervation, and smooth muscle elements may be found in their walls
upon histological examination.
In these investigations it was found that electrical stimulation of
the same nerves which were narcotized with novocaine with a resultant
therapeutic effect in thrornbophlebitic edema, actually resulted in
spasms of the lymph duct, or lymphangiospamus.
On the basis of these investigations it was concluded that a con-
tributing factor of thrombophiebitic edema is a reflect which causes
spasmodic contraction of the lymph duct, preventing fluid from leaving
the intersitium via the lymph duct.
Study of the phenomenon of ly=phangiospasmus led to further investi-
gation of the connection between the lymphatic system and the nervous
system. It was found in the tours' of experiments that not all the fluid
injected into a periferal lymph d>ct reaches the main lymph duct, the
ductus thoracicus, and thence into the blood system. It was found that
part of the injected fluid enters the blood system by first passing
through the walls of the lymph ducts, and part is absorbed into the blood
system through the lymph nodes. Part of the fluid remains for a time in
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the lymph ducts and in the lymph nodes. It was found that this phenomenon
could be effected by Dibenamin, a drug which effects the nervous system.
Experiments along this line led to the conclusion that contrary to the
earlier theory, lymphatic circulation is not passive, but is regulated by
the nervous system, similarly to the active nervous regulation of the
blood circulation.
The edema of heart patients also was studied from the point of view
of lymph circulation. In the latter 1880!s Cohnheim expressed the
opinion that edemic stasis is caused only by failure of the lymphatic
system to carry away the increased amount of fluid in the interstitium.
Volhard and Rouviere also have taken up this position in recent
literature.
Because of the importance of this problem, and because of the con-
tradictions appearing in the literature it appears necessary that an
attempt be made here to clarify this problem in the fight of several
experiments.
Because the-main lymph ducts empty into the venus system at the
angulus venosus, it is possible that in decompensated heart patients the
increased arterial pressure hinders the emptying of lymphatic ducts,
and the stasis is transferred to the lymph ducts, also. It was demon-
strated experimentally that if the pressure is increased in the large
arteries, this pressure backs up to the ductus thoracicus. On the
basis of these experiments it may be considered proved that an increase
in arterial pressure causes edema only if the lymphatic circulation also
is obstructed and that this is the reason for the difference detected
between the requisites for a local increase in venus pressure and a
general increase in pressure or cardial origin
The edema. of kidney patients is equally important as the edema of
cardiac patients. This problem also was investigated by the research
group in the course of their research. It was found that the large
efferent lymph ducts are greatly enlarged in animals made edemic by
plasmapheresis, and cannulp.tion of the ductus thoracicus showed the
amount of lymph collected much greater than normal. Because the capacity
of the lymph ducts is finite, if the amount of interstitial fluid
exceeds this capacity the lymph ducts cannot carry away all the fluid
and the fluid remaining in the tissue interstitial spaces forms an
edema.
By way of a brief summary of the investigation of the research
group in the field of the origin of edema it may be stated that the
formation of an edema is impossible as long as the lymph ducts are
capable of performing their function of conveying fluid. Edema results
only when lymphatic circulation is deficient. Deficient lymphatic
circulation may be caused by mechanical obstruction, anatomical ir-
regularity, spasm of the lymph ducts, or increased venal pressure which
hinders lymph removal. A dynamic deficiency also may occur if the
periferal production of fluid is so great that the lymphatic system
cannot carry away all of the fluid. Although it still has not been
verified, the possibility of periferal absorption becoming deficient
for some reason or other also must be allowed.
Following investigation of the role of lymphatic circulation in
various types of edema the research group undertook investigation of
the local influence of lymph circulation in the function of individual
organs.
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It is a generally known urological fact that closure, or experi-
mental blocking of the ureter, the efferent urinary duct, causes no
significant change in the kidney for a period of several weeks. According
to the data of Babics and Renyi-Vamos the injection of various substances
into the blood stream, such as inulin or indigocarmine, following tying
off of the ureter resulted in the appearance of these substances in the
tied-off renal cavity. Under similar conditions Jancso was able to
demonstrate the presence of inulin in the cells of the uriniferous tub-
ules by histochemical methods. According to Babics and Reny!-Vamos the
continued functioning of the tied-off kidney is explained by the move-
ment of the urine from the renal cavity into the renal tissue, from where
it is gradually absorbed into the lymph ducts. In the light of this
explanation there is no urinary stasis when the ureter is closed off.
The flow of urine continues, with the lymph ducts carrying off the
urine instead of its being passed through the ureter. This is the ex-
planation for the fact that deterioration of a blocked kidney begins only
after the lapse of a period of several weeks, and experience has shown
that kidney blocking does not result in death, but in slow consumption.
If the lymphatic system has such an important role in the pathologi-
cal conditions following ureteral closure the question arose as to what
would happen if both the ureter and the efferent lymph ducts of the
kidney were tied off.
It was established experimentally that tying off of both the ureter
and the kidney's efferent lymph ducts was followed within 2 or 3 days by
the most severe change, the death of the kidney.
The conclusions of Babics are important in this respect: if a con-
dition of renal block by a kidney stone in a human is accompanied by
inflammation of the renal peduncle, or pedunculitis, in which condition
the lymph ducts passing through the renal peduncle are closed off, no
attempt should be made at conservative treatment through removal of
the kidney stone, but the entire kidney should be removed because
according to his experience the kidney always is lost in such cases.
The investigation in connection with the liver was done with the
cooperation of Babics and Renyi-Vamos at the Budapest Urological Clinic
and Romhanti at the Pecs Institute of Pathological Anatomy.
The problem of the so-called Disse spaces has long been important
from the point of view of clinical, as well as anatomical and histo-
logical studies. Although numerous publications have appeared on this
problem, it still remains unsolved. The problem is whether in the
normal state there are fluid-containing interstitial spaces between
liver cell strands, or whether these spaces are an artifact.
The difficulty consists in the fact that the methods used were not
adequate for solution of the problem. The method used by most researchers
was the injection of various substances under high pressure into liver
tissue, and histological examination of the distribution of these sub-
stances, later. Therefore, it is questioned whether the facts observed
by this method are purely artificial or not.
The above research group proceeded on the theory that if the Disse
space existed and was part of the liver interstitiam, then blocking of
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the efferent lymph ducts must result in expansion of the Disse space,
because the protein-containing fluid could be led off from the inratitium
on through the lymphatic system.
In liver research, lymph stasis was successfully produced in the
liver by tying off of the lymph nodes of the liver. Histological exam-
ination revealed that under such conditions the Disse spaces were
exactly as in liver in#la.'amation caused by infection. On the basis of
the experiments of this group it was established that the Disse space
is not an artifact but is present in normal liver and is an integral
part of the liver interstitium.
Further experiments, similar to the above experiments on the liver,
were aimed at discovering the effect of tying off the efferent lymph
ducts of the liver on the results produced by tying off the ductus
choledochus, the common bile duct. These experiment-- -showed that the
tying off of both ducts led to far more serious consequences than tying
off only the ductus choledochus.
3. The Heart
These investigations were performed with the participation of Ferenc
Solti, Gyorgy Romhanyi of the Pecs Institute of Pathological Anatomy,
and Antal Temesvari of the Budapest Clinic of Advanced Surgical Training.
The experiments showed that blocking the lymphatic circulation of the
heart leads to severe histological changes; the heart muscle becomes
edemic, and in some cases small, scattered areas of dead tissue are
formed. The most important observations were that cardiac lymph stasis
has serious electrocardiographic results.
Although the above observations have no precedent in literature,
several researchers already have described venus circulatory disturb-
ances of the heart and their electrocardiographic consequences. Among
the latter researchers are the Hungarians Temesvari and Kunos of the
Budapest Clinic of Advanced Surgical Training, The essence of their
results is that tying off of the principal venus cavity of the heart,
the sinus coronarius, never leads to death of the heart muscle. At
most, this leads, after a certain period, to a mild increase in con-
nective tissue (fibrosis), and to a temporary depression in oscillations,
or low voltage (Unghvary). There are no serious electrocardiographic
consequences.
In light of the above, the question arose as torthat would happen
if the cardiac lymph ducts became obstructed when a condition of venous
stasis prevails, and there is increased need for the efferent lymphatic
circulation to maintain the lymphatic circulation of the heart muscle.
Therefore the results of simultaneous venous and lymphatic stasis were
investigated.
These experiments established that although tying off of either the
sinus coronarius or the cardiac lymph ducts alone did not endanger the
survival of the animal, the tying off of both ducts at the same time
usually led to the rapid death of the animal. Post mortem dissection
revealed the cause of death to be extensive hemorrhagic death of the
heart muscle. The electrocardiographic results were similar to those
obtained in human pathology in cases of blocking of the coronary arteries.
The research group drew several significant conclusions from these
observations. Firstly, from a general standpoint these facts give a strong
indication of the crucial role of lymph circulation in the life of the
heart muscle. Secondly, these observations are important because of
',heir implication in the cases in human pathology in which the death of
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some patients is accompanied by all the symptoms of coronary occlusion,
but autopsy reveals no pathological changes in the coronary arteries.
From the investigations of this research group it may be concluded that
closure of the cardiac arteries is fatal only if accompanied by closure
of both the venous and lymphatic ducts. In connection with spasm of the
lymph ducts mentioned above, or lymphangiospasmus, this group proposes
that venous occlusion may lead to a lymphangiospamus in the form of a
reflex action. This area of research has such great theoretical and
practical significance that further research on clinical patient material
is absolutely necessary.
These investigations also have very important implications for the
pathological course of certain human cardiac diseases, including cardiac
decompensation. In cases in which exhaustion of the left side of the
heart is followed by secondary decompensation of the right side of the
heart, the systemic and the cardiac arterial pressure rises. Also, as
was mentioned above, an increase in arterial pressure hinders the emptying
of lymph from the lymphatic ducts into the large arteries. This causes
a sudden deterioration of cardiac venous circulation which, as was seen
above, has fatal effects on the heart muscle.
It has long been known that the lung has an extensive lymph duct
system. The clinical picture of pulmonary edema also has been known for
a long tL:_e. Despite these facts, all the details of the origin of
pulmonary edema still are not sufficiently well known, especially con-
cerning the role of pulmonary lymph circulation in the fluid circulation
of the lung under normal and pathological conditions. The theory gen-
erally held, which was first proposed by Welch, is that pulmonary edema
rises when the left side of the heart becomes deficient and the right
side of the heart continues normal. In this situation the blood pressure
in the capillaries in the lung region of the inferior circulatory system
greatly exceeds the pressure tending to keep the blood fluids within the
blood vessels, and pulmonary edema results, with fluid filling the
pulmonary vescicles. This hinders the exchange of gases, and if this
condition extends to a large part of the lung the patient suffocates.
In this instance, as in many other cases, the extensive lymph circul-
ation of the lungs has been overlooked.
In experiments conducted by Janos Kepes, an associate of the National
Scientific Research Institute of Nerve Surgery, Ferenc Robicsek, an
associate professor of the Budapest Clinic for Advanced Surgical
Training, and Miklos Papp, who is a degree aspirant under the sponsorship
of the present author, it was established that pulmonary edema could be
produced by tying off the efferent pulmonary lymph ducts.- Although the
edema produced in this way could be definitely identified, it did not
extend to a majority of the pulmonary vescicles. When the heart valves
of a dog were first damaged, however, tying off of the lymph ducts led
to diffuse, extensive and serious pulmonary edema.
On the basis of these investigations this research group drew up a
new definition of the origin of pulmonary edema: pulmonary edema results
in all cases in which there is a decrepency between the production of
pulmonary capillary filtrate and removal of the latter, or in all cases
in which the pulmonary lymph duct system is deficient and incapable of
keeping the lung ttdry." The occurrence of pulmonary edema, whether due
to an increase in pulmonary capillary blood pressure, to a decrease in
colloidal osmotic pressure (drop in the affinity of proteins for water),
to an increase in the permeability of capillaries of the inferior cir-
culatory system, or to the presence of water in the air passages, in the
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final analysis the edema is always the result of some type of deficiency
in the lymphatic circulation of the lungs.
One of the most important preparations of the field of physiology,
pathology, and pharmacy is the so-called Starling heart-lung preparation.
Study of his preparation led to discovery of most of the known laws
governing the functioning of the heart. A very annoying circumstance
is that the use of the Starling heart-lung preparation always leads to
the spontaneous development of pulmonary edema after a certain period of
time. Starling himself observed and recorded this fact, but its causes
still have not been explained. Most authors attempt to explain this
phenomenon by the liberation of toxic substances from the dog blood
which is artificially pumped through the heart and lungs, and which have
a damaging effect on the walls of the arteries. On the basis of its own
experiments the above research group is able to contribute a very
important fact to knowledge of this problem. The Starling heart-lung
preparation requires the preliminary tying-off of the large veins leading
to the heart. This hinders the emptying of lymph from the large lymph
ducts into the large veins. This, however, does not preclude the possible
toxic effect of the blood used for perfusion.
These investigations were performed in conjunction with Harry
Jellinek, an associate professor of the Budapest Institute of Pathological
Anatomy No II. It is a long-disputed question, whether the netabolisrri
regulating hormone produced by the thyroid, the so-called acinus
secretions, leave the thyroid gland via the blood stream or via the
lymphatic ducts.
In the first group of experiments the lymph ducts of the thyroid gl^nd
were made visible by tying off the two principal efferent lymph ducts
in the neck of a dog. This rendered visible the thyroid lvmnh ducts
which otherwise are collapsed and cannot be observed even in histological
examinations, and the course, location, and relation of these .Lyr;_ph ducts
to blood vessels and to the acinus secretions could be studied in detail.
The incisions were stained with extremely varied types of dyes and it
was found that in every case the gland secretion in the acini and the
lymph in the distended lymph ducts of the thyroid gland showed the
identical staining results. At the same time, the lymph in the ductus
thoracicus exhibited different staining characteristics. From these
investigations it may be concluded that the content of the acini and of
the thyroidal lymph ducts is identical, and that the lymphatic system
of the thyroid has an active part in carrying off the hormone produced
by the thyroid gland. Nevertheless, further investigations will be
necessary to prove this hypothesis.
In the second group of experiments large numbers of human thyroid
glands were examined. It was established that pathological changes may
be found in the lymph duct system in cases of colloidal goiter, which
most probably have an important role in the development of transformations,
scarring and death of thyroid connecting tissue.
An extensive series of experiments was undertaken to determine the
mechanism by which various substances present in the interstitium,
such as fluid, protein, bacteria, etc, get into the lymph capillaries,
which begin as a closed system, shaped like a glove. (It must be noted
here that no one has had as much success as academician Miklos Jancso
in his recent classical photographs which demonstrate that lymph
capillaries originate in this manner.)
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From these investigations it was concluded that the function of the
endothelial cells which compose the walls of the lymph capillaries is
the regulation, or active limitation in the living organism of absorption
into the capillaries. It must be noted that this phenomenon is not
unique in the life of the organism, and the same thing happens in both
the stomach and the renal cortex.
The Urological Clinic, headed by acadenucian Babicss, plays an
important, role in Hungarian lymph research, The principal research results
of Babics and Renyi-Vrrros are described below.
Through electrophoretic experiments Babics and Renyi-Vamos have
demonstrated that lymph taken from extremely diverse parts of the body
(intestine, testicles, liver, kidney, appendages, ductus thoracicus)
contains the same proteins which are found in blood, However, there is
a definite, demonstrable difference between the composition of lymph
and blood protein.
This research group demonstrated that in the hydronephrosis?
resulting; from tying off of the ureter the lymph capillaries distend
and they may be counted-and their location may be stud-'ed. They showed
that the liver contains many lymph capillaries, but contrary to earlier
data there is no system of lymph ducts. 'The :nvest-ations of Babics ?
and Renyi-Vamos along this line contr .bated gr _ at l.v to the }'srowledge of
the kidney lymphatic duct system.
In further experiments it, was establ:shed that '-ontrary to previous
opinion, that in both humans and in exrerimental r.n:mals inflammatory
processes of the renal nervous system do not invade the kidney substance
via the lymph ducts, but through the fatty and cconc give tissue, with
the exclusion of the lymph ducts.
The investigations of the Budapest Urolog- a1 Clinic 5n the field
of the pathology of pyelonephritis have great pra-_tical significance.
In these investigations it was shown that the sts s and anflarr,mation of
protein in the kidney tissue and in the renal tun2.c. causes the formation
of scar tissue in the tunic, peduncle and in the fatty tissue surrounding
the renal cavity, which compresses the effer:nt lymph dusts. These pro-
cesses explain the phenomenon of the shrinkage of the kidney in pyelone-
phritis. On the basis of these ooservation= a therapeutic standard was
developed for the treatment of chronic Fyelonephrit_s according to which
surgical removal of the stone is insulfic:.ient, and if the kidney is worth
retaining, the scar tissue must be removed as well- With such treatment
the functioning of the kidney improves, and the pathological configura-
tion of the renal ?aviLy system also reverts to norr.al.
Renyi-Vamos and Gyorgy Rona, lecturer of the Institute of Pathological
Anatomy No 1, investigated the problem of why the renal lymph capillaries
do not distend in acute and subacute glomerulor.ephr:t-3, despite the
existing edema. In the opinion of these resear.:hers deficient lymphatic
circulation is one of the causes of the develoi-..en: of shrunken kidney,
which is the fat?: result of chronic renal infection.
Renyi-Vamos and Gyula Szanay, lecturer of the Budapest Institute of
Pathological Anatomy, investigated the anatomy of the lymphatic system
of the stomach, and the role of the gastric lymphati system in the
pathology of gastric ulcer.
Renyi-Vamos made some i:rportant new observations in the investigations
concerning the testicle. On the basis of his observations he drew the
conclusion that whereas, contrary to the general opinion there are no
 lymph capillaries in the ducts between the testicle and the enididymis,
such lymph capillaries can have no role in furthering the development of
tuberculosis. Tuberculosis of the testicle, therefore, is not lymphogenous
as was previously thought, but is transmitted directly to the testicle
tissue.
Whereas there are no lymph capillaries between the testicular ducts,
the removal of fluids accumulated due to edeme of the testicular tissue
during an illness or the increase of such fluid following hemorrhage
caused by injury is very slow. This is thought to be the cause of the
clinical observation of the rapid death of the testicle in testicular
conditions accompanied by extreme edema. In less severe cases the result
is not the death or the organ, but the formation of scar tissue. Based
on the above, Babies developed the therapeutic conclusion that in cases
of injury to the testicular integument the extruding testicular tissue
should not be replaced, as is the present practice, but should be
excised. It has long been known in clinical practice that novocaine
treatment in cases of inflammation of the testicle and epididynis has a
beneficial effect. Babics and Renyi-Vamos, then, are justified in
thinking that in such cases elimination of the lymph duct spasms has
some effect in the therapeutic treatment.
Finally, it may be mentioned that Babics and Renyi-Vamos have stated
that if the Funiculus spermaticus (the fascicle containing the efferent
duct of the testicle, the testicular arteries, lymph ducts and nerves)
is thick, turgid, very sensitive, and the condition persists for 6 to 8
days, it is certain that the condition has spread to the testicle and
the testicle no longer can be saved. In such a_ condition the efferent
lymph ducts located in the Iuniculus have be _en blocked off, and the
testicle must perish.
In conclusion, the research of Istvan Kubik, lecturer of the Budapest
Institute of Anatory, in the field of lymph circulation may be mentioned.
Kubik was especially concerned with investigation of the factors which
play a role in the maintenance of lymphatic flow. In another research
project Kubik investigated the lymphatic system of the uterus and con-
tributed to the clarification of the anatomy of the lymphatic plexus of
the uterine mucous cezbrance. He established that this plexus has a
definite embryonic character, because due to the rapid succession of
slo, ling off of the mucous membrane in menstruation the lymphatic plexus
has no opportunity for differentiation. Another interesting observation
of this research is that the lymph ducts originating in the outermost
regions of the genital system pass through more lymph nodes than the
ducts leading from the inner regic'ls. Thus the regions which are
exposed to greater possibility of infection are protected by greater
filtration of the lymph.
In his book entitled A tudo seementumok localisatio.ja a tajeki
n irokcsomokban ZEocalizat_on of Lung Segments in the Regional Lymph
Nodes J, Kubik discusses the possibility of localization of the smaller
units of each lung lobe, the lung segments, within the lymph nodes of the
hilus. On the basis of his experiments he was able to localize the
lymph nodes of the individual lung segments, and he even succeeded in
isolating the distribution of appropriate segments within individual
lymph nodes. On the basis of this study the primary units which com-
pose a lymph node may be defined. As a result of these investigations
it may be demonstrated that from the point of view of lymphatic cir-
culation the segmentum is an independent unit. The study of this problem
is of importance to pulmonary surgery, also.
 Kubik also investigated the problem of the innervation of lymph ducts,
and after Zhdanov, he was the first to study this problem through utili-
zation of silver-impregnation photographs. Kubic succeeded in demon-
strating the so-called basic plexus of the intestinal. folds, including
the small secondary branches, the innervation of which never before had
been demonstrated. He discovered a peculiar, network-like nervous plexus
on the larger lymph ducts which, according to denervation exper'_nents,
apparently constitute a receptor grid. This problem is especially
important in view of the fact that according to Soviet data various blood
circulatory reflexes are governed by the lymphatic circulation. From
Soviet literature it is known that experimental increase of the pressure
in the ductus thora_cicus results in an increase in blood pressure, and
Kubik demonstrated that the same phenomenon may be observed in experiments
with the abdo..ninal and neck lymphatic vessels, also.
In the above the author has attempted to give a brief review of the
work which has been done in Hungary since the liberation in the field of
the physiology and pathology of the lymphatic system. This work already
has had many new and interesting results and extends the hope that in the
future it will further enrich medical science with knowledge of both
theoretical and practical importance.